Embodiments of the present invention generally relate to programming of neurostimulators and more particularly to methods and systems to assist in programming neurostimulators based on a collection of pre-existing therapy profiles.
Neurostimulation systems are devices that generate electrical pulses and deliver the pulses to nerve tissue to treat a variety of disorders. Spinal cord stimulation (SCS) is the most common type of neurostimulation. In SCS, electrical pulses are delivered to nerve tissue in the spine typically for the purpose of chronic pain control. While a precise understanding of the interaction between the applied electrical energy and the nervous tissue is not fully appreciated, it is known that application of an electrical field to spinal nervous tissue can effectively mask certain types of pain transmitted from regions of the body associated with the stimulated nerve tissue. Applying electrical energy to the spinal cord associated with regions of the body afflicted with chronic pain can induce “paresthesia” (a subjective sensation of numbness or tingling) in the afflicted bodily regions. Thereby, paresthesia can effectively mask the transmission of non-acute pain sensations to the brain.
SCS systems generally include a pulse generator and one or more leads. A stimulation lead includes a lead body of insulative material that encloses wire conductors. The distal end of the stimulation lead includes multiple electrodes that are electrically coupled to the wire conductors. The proximal end of the lead body includes multiple terminals, which are also electrically coupled to the wire conductors that are adapted to receive electrical pulses. The distal end of a respective stimulation lead is implanted within the epidural space to deliver the electrical pulses to the appropriate nerve tissue within the spinal cord that corresponds to the dermatome(s) in which the patient experiences chronic pain. The stimulation leads are then tunneled to another location within the patient's body to be electrically connected with a pulse generator or, alternatively, to an “extension.”
The pulse generator is typically implanted within a subcutaneous pocket created during the implantation procedure. In SCS, the subcutaneous pocket is typically disposed in a lower back region, although subclavicular implantations and lower abdominal implantations are commonly employed for other types of neuromodulation therapies. The pulse generator is typically implemented using a metallic housing that encloses circuitry for generating the electrical pulses, control circuitry, communication circuitry, a rechargeable battery, etc. The pulse generating circuitry is coupled to one or more stimulation leads through electrical connections provided in a “header” of the pulse generator.
Existing programmer devices for neurostimulators do not provide any programming assistance or recommendations to a clinician regarding stimulation programs that may be effective for a patient exhibiting certain characteristics. Instead, existing programmer devices act as dumb interfaces forcing the clinician to rely on his or her training and experience in determine the stimulation parameters that may be effective. This process is time consuming and success of the outcome may vary across patients, sessions, and clinicians. Training of new clinicians is expensive and time-consuming because existing neurostimulator and programming devices requires a solid understanding of anatomical, physiological, and electrical principles. Existing devices do not leverage the collective programming knowledge of existing clinicians to promote good programming practices and avoid programs that tend to be ineffective.
For purposes of spinal cord stimulation (SCS), or the controlled application of specific electrical energy to certain spinal nervous tissue to manage the transmission of specialized pain signals through such tissue, systems have been proposed that map “pain” data to predetermined regions of the patient. Pain maps have been drawn on a graphical image of a human figure. However, pain maps for individual patients are not readily accessible to clinicians who are trying to determine what stimulation program would be effective with another patient.
Further, current technology does not afford a mechanism to utilize pain maps from multiple patients in connection with determining stimulation programs for new patients.
Another negative characteristic of current technology is the limited amount (and quality) of pain-related information recorded and considered. In particular, indicating pain relative to a human representation simply provides relative location information. Any pain characteristics are limited to an intensity value, which is entered through a textual-based, numeric input mechanism.
Consequently, a need exists for a system that enables an object, whether predisposed to regional division or not, to be mapped into a plurality of regions, each region being capable of capturing region-specific and/or object-specific data. A need exists for a system in which users can consistently and reliably enter information attributable to any given region. A need exists for a system that would enable data for any given lead attribute or pain map to be compared, universally modified, and/or otherwise manipulated among a plurality of programming devices.